Why am I not getting pregnant the second time? Expert answers

Planning a second pregnancy can be an exciting phase for couples, however, it comes as a surprise to a few when they face problems in conceiving. As a woman's fertility drops with age, it can be more difficult to conceive a second child than it was with the first. In medical terms, it is called secondary infertility, when a difficulty occurs in becoming pregnant after a previous successful natural conception, gestation and birth. In these scenarios, fertility treatments can cure secondary infertility. According to a recent study, infertility affects over 12.5% of couples trying to conceive, with secondary infertility accounting for about half of all occurrences.

Issues with the female or male partner might induce secondary infertility. Around 33% of all infertility cases are caused by problems with the female partner whereas the next 33% are caused by problems with the male partner. The remaining 33% of overall infertility cases are a mix of concerns involving both the male and female partners.

These reasons are responsible for secondary infertility:

Dr. Aneesha Grover, Infertility Specialist, Nova IVF Fertility, says "Women release one egg during each menstrual cycle. As one matures, one produces fewer and inferior quality eggs, reducing the chances of becoming pregnant naturally. In general, a woman's fertility peaks in her mid-to-late twenties, following which it gradually declines until age 35, after which there is a steep decline."

However, each woman is unique, and the decline can occur sooner or later. Because fertility falls with age, it's frequent for women who had no trouble conceiving their first child to struggle with conception when they're older and less fertile the second time around.

Infertility can also be caused by uterine problems, such as adenomyosis which is caused by tissue enlargement inside the walls of the uterus, or scarring from a C-section or fibroids which leads up to inflammation or blockages, making it more difficult to become pregnant.

PCOS (Polycystic Ovary Syndrome) is a hormonal condition that causes women to have irregular or lengthy periods. PCOS individuals may include high levels of androgen (male hormones). A small accumulation of fluid around the ovaries is common in PCOS patients, preventing eggs from releasing.

"Low sperm count, Azoospermia and other sperm abnormalities may prevent the sperm from reaching the egg and fertilizing it," says Dr. Grover.

Some men and women have antisperm antibodies, which make getting pregnant difficult.

However, it’s very much possible to become pregnant the second time with the correct procedures and guidance and assistance from a fertility doctor. WIth the help of certain lifestyle changes and medication helps improve fertility in men and women both.

In order to rule out rare causes, one of the first steps includes doing a fertility test to help you learn the cause so you can move ahead with the appropriate treatment. Before beginning the treatment, people also undergo diagnostic testing to acquire a full picture of their fertility. This includes fertility bloodwork to understand more about a patient's egg count and determine if she is experiencing secondary infertility.

There are various treatment options such as Intrauterine Insemination (IUI) in which sperm is placed into a woman's uterus at the time of ovulation and In Vitro Fertilization (IVF) which involves fertilizing sperm and eggs outside of the woman's body and then inserting the resulting embryo back into her uterus in the hopes of implantation. These treatments are selected based on a woman’s reproductive characteristics.

Disclaimer: The views and opinions expressed by the doctors are their independent professional judgment and we do not take any responsibility for the accuracy of their views. This should not be considered as a substitute for physician's advice. Please consult your treating physician for more details.